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Vascular disease includes any condition that affects the circulatory system. As the heart beats, it pumps blood through a system of blood vessels called the circulatory system. The vessels are elastic tubes that carry blood to every part of the body. Arteries carry blood away from the heart while veins return it.
Vascular disease ranges from diseases of your arteries, veins, and lymph vessels to blood disorders that affect circulation. The following are conditions that fall under the category of vascular disease.
Peripheral Artery Disease
Like the blood vessels of the heart (coronary arteries), your peripheral arteries (blood vessels outside your heart) also may develop atherosclerosis, the build-up of fat and cholesterol deposits, called plaque, on the inside walls. Over time, the build-up narrows the artery. Eventually the narrowed artery causes less blood to flow and a condition called "ischemia" can occur. Ischemia is inadequate blood flow to the body's tissue.
- A blockage in the coronary arteries can cause symptoms of chest pain (angina) or a heart attack.
- A blockage in the carotid arteries (the arteries supplying the brain) can lead to a transient ischemic attack (TIA) or stroke.
- A blockage in the legs can lead to leg pain or cramps with activity (a condition called claudication), changes in skin color, sores or ulcers, and feeling tired in the legs. Total loss of circulation can lead to gangrene and loss of a limb.
- A blockage in the renal arteries (arteries supplying the kidneys) can cause renal artery disease (stenosis). The symptoms include uncontrolled hypertension (high blood pressure), heart failure, and abnormal kidney function.
An aneurysm is an abnormal bulge in the wall of a blood vessel. They can form in any blood vessel, but they occur most commonly in the aorta (aortic aneurysm) which is the main blood vessel leaving the heart. The two types of aortic aneurysm are:
- Thoracic aortic aneurysm (part of aorta in the chest)
- Abdominal aortic aneurysm
Small aneurysms generally pose no threat. However, one is at increased risk for:
- Atherosclerotic plaque (fat and calcium deposits) formation at the site of the aneurysm.
- A clot (thrombus) may form at the site and dislodge.
- Increase in the aneurysm size, causing it to press on other organs, causing pain.
- Aneurysm rupture -- because the artery wall thins at this spot, it is fragile and may burst under stress. A sudden rupture of an aortic aneurysm may be life threatening.
Renal (Kidney) Artery Disease
Renal artery disease is most commonly caused by atherosclerosis of the renal arteries (see above). It occurs in people with generalized vascular disease. Less often, renal artery disease can be caused by a congenital (present at birth) abnormal development of the tissue that makes up the renal arteries. This type of renal artery disease occurs in younger age groups.
Raynaud's Phenomenon (Also Called Raynaud's Disease or Raynaud's Syndrome)
Raynaud's phenomenon consists of spasms of the small arteries of the fingers and sometimes the toes, brought on by exposure to cold or excitement. Certain occupational exposures bring on Raynaud's. The episodes produce temporary lack of blood supply to the area, causing the skin to appear white or bluish and cold or numb. In some cases, the symptoms of Raynaud's may be related to underlying diseases (ie, lupus, rheumatoid arthritis, scleroderma).
Buerger's disease most commonly affects the small and medium sized arteries, veins, and nerves. Although the cause is unknown, there is a strong association with tobacco use or exposure. The arteries of the arms and legs become narrowed or blocked, causing lack of blood supply (ischemia) to the fingers, hands, toes, and feet. Pain occurs in the arms, hands and, more frequently, the legs and feet, even when at rest. With severe blockages, the tissue may die (gangrene), requiring amputation of the fingers and toes.
Superficial vein inflammation and symptoms of Raynaud's occur commonly in patients with Buerger's disease.
Peripheral Venous Disease
Veins are flexible, hollow tubes with flaps inside called valves. When your muscles contract, the valves open and blood moves through the veins. When your muscles relax, the valves close, keeping blood flowing in one direction through the veins.
If the valves inside your veins become damaged, the valves may not close completely. This allows blood to flow in both directions. When your muscles relax, the valves inside the damaged vein(s) will not be able to hold the blood. This can cause pooling of blood or swelling in the veins. The veins bulge and appear as ropes under the skin. The blood begins to move more slowly through the veins, it may stick to the sides of the vessel walls and blood clots can form.
Varicose veins are bulging, swollen, purple, ropy veins, seen just under your skin, caused by damaged valves within the veins. They are more common in women than men and often run in families. They can also be caused by pregnancy, being severely overweight, or by standing for long periods of time. The symptoms of varicose veins include:
- Bulging, swollen, purple, ropy, veins seen under the skin.
- Spider veins -- small red or purple bursts on your knees, calves, or thighs, caused by swollen capillaries (small blood vessels).
- Aching, stinging, or swelling of the legs at the end of the day.
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Blood Clots In the Veins
Blood clots in the veins are usually caused by:
- Long bed rest and/or immobility.
- Damage to veins from injury or infection.
- Damage to the valves in the vein, causing pooling near the valve flaps.
- Pregnancy and hormones (such as estrogen or birth control pills).
- Genetic disorders.
- Conditions causing slowed blood flow or thicker blood, such as congestive heart failure (CHF), or certain tumors.
There are many types of blood clots that can occur in the veins:
- Deep vein thrombosis (DVT) is a blood clot occurring in a deep vein.
- Pulmonary embolism is a blood clot that breaks loose from a vein and travels to the lungs.
- Chronic venous insufficiency isn't a blood clot, but a condition that occurs when damaged vein valves or a DVT causes long-term pooling of blood and swelling in the legs. If uncontrolled, fluid will leak into the surrounding tissues in the ankles and feet, and may eventually cause skin breakdown and ulceration.
Blood Clotting Disorders
Blood clotting disorders are conditions that make the blood more likely to form blood clots in the arteries and veins. These conditions may be inherited (congenital, occurring at birth) or acquired during life and include:
- Elevated levels of factors in the blood which cause blood to clot (fibrinogen, factor 8, prothrombin).
- Deficiency of natural anticoagulant (blood-thinning) proteins (antithrombin, protein C, protein S).
- Elevated blood counts.
- Abnormal fibrinolysis (the breakdown of fibrin).
- Abnormal changes in the lining of the blood vessels (endothelium).
The lymphatic system is a circulatory system that includes an extensive network of lymph vessels and lymph nodes. The lymphatic system helps coordinate the immune system's function to protect the body from foreign substances.
Primary lymphedema is rare and is caused by the absence of certain lymph vessels at birth, or it may be caused by abnormalities in the lymphatic vessels.
Secondary lymphedema occurs as a result of a blockage or interruption that alters the lymphatic system. Secondary lymphedema can develop from an infection, malignancy, surgery, scar tissue formation, trauma, deep vein thrombosis (DVT), radiation, or other cancer treatment.
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Arteriovenous MalformationArteriovenous malformation (AVM) is a congenital disorder of blood vessels in the brain, brainstem, or spinal cord that is characterized by a complex, tangled web of abnormal arteries and veins connected by one or more fistulas (abnormal communications). Symptoms of arteriovenous malformations include seizures and headaches. Treatment of arteriovenous malformations include medication or surgery.
BrachytherapyThis treatment involves administering radiation to a coronary artery that has narrowed after a stent has been implanted. Angioplasty is performed to gain access to the narrowed coronary artery. Radioactive material is then advanced through a catheter to the site of the blockage. Blood clots may occur at the site of radiation months after the procedure is performed.
Cholesterol TestA cholesterol blood test measures the amount of cholesterol in the body. There are two types of cholesterol; the "good" cholesterol or HDL, and the "bad" cholesterol or LDL. High cholesterol levels in the blood can lead to heart attack, stroke, and peripheral vascular disease. Learn more about cholesterol tests and how to interpret them.
Connective Tissue Disease
Connective tissue disease is when the body's connective tissues come under attack, possibly becoming injured by inflammation. Inherited connective tissue diseases include Marfan syndrome and Ehlers-Danlos syndrome. Systemic lupus erythematosus, rheumatoid arthritis, scleroderma, polymositis, and dermatomyositis are examples of connective tissue diseases that have no known cause.
CT Scan vs. MRI
CT scan (computerized tomography) is a procedure that uses X-rays to scan and take images of cross-sections of parts of the body. CT scan can help diagnose broken bones, tumors or lesions in areas of the body, blood clots in the brain, legs, and lung, and lung infections or diseases like pneumonia or emphysema.
MRI (magnetic resonance imaging) is a procedure that uses strong magnetic fields and radiofrequency energy to make images of parts of the body, particularly, the organs and soft tissues like tendons and cartilage.
Both CT and MRI are painless, however, MRI can be more bothersome to some individuals who are claustrophobic, or suffer from anxiety or panic disorders due to the enclosed space and noise the machine makes.
MRI costs more than CT, while CT is a quicker and more comfortable test for the patient.
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Erectile Dysfunction (ED, Impotence)Erectile dysfunction (ED, impotence) is the failure to achieve or maintain an erection. There are many potential underlying causes of erectile dysfunction, including stress and emotional problems, brain dysfunction, problems with blood supply to the penis, and structural problems with the penis. Erectile dysfunction is diagnosed by taking the patient's history and physical exam. Blood tests measuring kidney function and blood sugar, cholesterol, hormone, and prostate-specific antigen (PSA) levels may be ordered. Urinalysis, ultrasound, and other more sophisticated tests may be required. The treatment of erectile dysfunction depends on the underlying cause. Medications, penile injections, penile implants, and vacuum devices may be used. Treatment for erectile dysfunction is usually successful. The patient should manage heart disease risk factors (high blood pressure, high cholesterol, diabetes) as they are related to erectile dysfunction risk.
ParathyroidectomyParathyroidectomy is the removal of one or more of the parathyroid glands to treat hyperparathyroidism. Risks of parathyroidectomy include:
- paralysis of the vocal cords,
- difficulty swallowing thin liquids,
- difficulty breathing,
- and drug reactions.
- damage to the recurrent laryngeal nerve,
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Peripheral Vascular DiseasePeripheral vascular disease (PVD) refers to diseases of the blood vessels (arteries and veins) located outside the heart and brain. While there are many causes of peripheral vascular disease, doctors commonly use the term peripheral vascular disease to refer to peripheral artery disease (peripheral arterial disease, PAD), a condition that develops when the arteries that supply blood to the internal organs, arms, and legs become completely or partially blocked as a result of atherosclerosis. Peripheral artery disease symptoms include intermittent leg pain while walking, leg pain at rest, numbness in the legs or feet, and poor wound healing in the legs or feet. Treatment for peripheral artery disease include lifestyle measures, medication, angioplasty, and surgery.
Staph Infection (Staphylococcus Aureus)
Staphylococcus or staph is a group of bacteria that can cause a multitude of diseases. Staph infections can cause illness directly by infection or indirectly by the toxins they produce. Symptoms and signs of a staph infection include redness, swelling, pain, and drainage of pus. Minor skin infections are treated with an antibiotic ointment, while more serious infections are treated with intravenous antibiotics.
VasculitisVasculitis (arteritis, angiitis) is a general term for a group of uncommon diseases which feature inflammation of the blood vessels. Each form of vasculitis has its own characteristic pattern of symptoms. The diagnosis of vasculitis is definitively established after a biopsy of involved tissue demonstrates the pattern of blood vessel inflammation. Treatment is directed toward decreasing the inflammation of the arteries and improving the function of affected organs.